Dayton blames tech vendor IBM Curam for many of MNsure's problems

Gov. Mark Dayton has accused one of MNsure’s main technology vendors of misleading the health insurance exchange about the status and reliability of its product — a key system used to determine insurance eligibility.

Problems with the function have plagued MNsure since its launch.

“These errors have forced MNsure staff to spend thousands of hours trying to clean data and make consumers whole,” Dayton wrote in a Dec. 13 letter [PDF] to IBM CEO Virginia Rometty.

“Your product has not delivered promised functionality and has seriously hindered Minnesotans' abilities to purchase health insurance or apply for public health care programs through MNsure,” the governor wrote. “I request that you immediately deploy whatever people or resources are needed to correct the defects in your product that are preventing Minnesotans from obtaining health insurance through MNsure.”

Since the letter, Dayton and MNsure officials have had at least one conference call with IBM, and the company has sent at least 80 tech workers to address some of the issues.

IBM response

In a written statement responding to Dayton's criticisms, IBM spokesperson Mary Welder said: "The majority of concerns with the Curam software that were expressed by Governor Dayton three weeks ago have been addressed. These are not the only issues related to the performance of the MNSure system.

"IBM is just one of several subcontractors working on this project. The prime contractor, Maximus, Inc, has overall responsibility for the MNsure system including integration and testing of all the components prior to October 1. IBM continues to work closely with the other suppliers and the State of Minnesota to make MNsure a more positive experience for Minnesota citizens.

"As an example, the percent of suspended applications for coverage decreased by two thirds between mid-December and early January and the system is now handling cases at over a 95% daily success rate.

"To sustain the progress, we are providing on-site services and technical resources beyond the scope of IBM's contractual responsibilities to assist the State in resolving the remaining issues as quickly as possible. IBM Senior Vice President for Software Solutions, Mike Rhodin, has made this project a priority and has been in regular contact with Governor Dayton and the MNSure leaders. Although our original role on this project was limited, we are bringing the full resources and capabilities of IBM to the State because of the importance of the success of the project."

'Some progress' seen

In public discussions of IBM’s “tech surge” and the string of serious IT glitches that preceded it, Dayton and MNsure officials have used guarded language in describing the fixes.

Earlier this week, MNsure interim CEO Scott Leitz said that the health exchange and IBM were making “some progress” addressing the issues.

At Monday’s MNsure board meeting, Leitz said that the vendor had made significant progress identifying issues with the system.

“While there were challenges and continue to be within the IBM Curam product, we know that throughout the end-to-end system — which isn’t just IBM Curam, it’s other vendors as well — we will want to actually take a much more holistic look at that,” Leitz said.

MNsure’s leadership also has discussed the possibility of considering new firms to continue fixing the exchange. That decision isn’t expected for some time, at least until staffers have done the full system review.

Dayton critical of exchange’s performance

Dayton didn’t hold back in his Dec. 13 letter, which came a few days before former MNsure Executive Director April Todd-Malmlov stepped down amid the marketplace’s technical failings. The letter marks the beginnings of Dayton’s harsh criticisms of the exchange, and later that day he called its performance “unacceptable.”

“Your product has made it impossible to provide Minnesotans with any reasonable customer service.” Dayton wrote to IBM’s Rometty.

When IBM Curam sold MNsure on its tool in 2011, Dayton wrote, the company described it as 90 percent complete and off-the-shelf ready. MNsure had stressed the importance of a ready-to-go system in getting the exchange completed under tight time constraints.

MinnPost photo by James NordGov. Mark Dayton

“We now know that the product is still not 90 percent complete in December of 2013, and that your product has significant defects, which have seriously harmed Minnesota consumers,” the governor wrote.

The system, however, was never tested by state officials before buying it, according to a Minnesota Public Radio report.

In addition to calling out IBM Curam for misleading exchange officials about the completeness of its product, Dayton also criticized the company for specific technical failings.

He said those flaws have made it difficult for consumers to use the exchange and have given those that do get through incorrect tax credit and public program eligibility determinations.

These “significant” technical flaws became apparent shortly after MNsure’s Oct. 1launch, according to Dayton.

List details problems

In an attached list of issues with system [PDF], the exchange said state staffers discovered another verification issue on their own through tracking logs, even though IBM Curam was aware of it. MNsure said the problem was one of the reasons it had to re-run about 30,000 consumer applications.

The verification problems also in part caused call center spikes, delays in invoices and significant difficulties in sending consumer enrollment information electronically to the health carriers, MNSure said. The list describes nearly every widespread problem MNsure has experienced in the last two months as a product of the software.

The litany of concerns also references a “black hole” in the system, where staff can’t find applications.

“Clients submit an application online and potentially even enroll and pay for a plan but we have no record of them in the eligibility system,” according to the letter. “There are over 2,600 of these … and Curam cannot tell us how many are cases or just error messages. They also cannot tell us who they are and they cannot get them out of this black hole.”

Exchange staff also identified a security flaw in which it took 30 minutes to automatically log a user out of the system. That poses significant privacy risks for consumers who do group enrollment events at libraries and public computer labs.

MNsure told the vendor to reduce that time to 10 minutes, and IBM said it complied. But when exchange staff went back to check, it wasn’t fixed.

It’s unclear how many of these problems since have been addressed. MNsure didn’t immediately return a request for comment.

Exchange staff said on Monday after a governing board meeting that there are some applications that are “stuck” in the system.

IBM Curam is scheduled to receive at least $3.96 million for its tools.

Other vendors on the more than $40 million project include Maximus Inc., EngagePoint, Connecture and PricewaterhouseCoopers, LLP.

It would be simplistic for Dayton to take all of the responsibility for the rollout problems. There were many politicians, state employees and vendors who share in that responsibility. If Dayton took all the blame, it would be purely symbolic and do little to address the problems. As the chief executive, he has to take ultimate responsibility, but, to the best of my knowledge, he's not an IT professional.

Let's all turn from blaming to building. After considering the list of 21 MNsure performance issues, some appear to be fundamental flaws to the process, not mere "glitches." Perhaps a hollow feeling should temper commentary as we digest these revelations, particularly the need to build internal elements, not simply repair faulty ones. One source of dismay is the fundamental failure to properly consider Minnesota's extensively complex regulatory codes. Yes, there are failures at nearly all levels of this project by both customer and contractor. Let's all chill for a bit while they get this right, as long as they continue to tell us what is right... and not yet right.

…to Mike Downing's comment might make it more accurate. That would be to change "Governor Dayton" to "IBM CEO Virginia Rometty." Doing so is no more mindlessly simplistic than Mr. Downing's charge.

As David LaPorte points out, Dayton is not an IT professional, and even if he were, it's unlikely he'd be writing all the necessary code to get the system up and running. Getting big systems like this to work properly is always a team effort, and in this case, the "team" relied heavily on one or more private sector companies who apparently promised the state that their products could do the job when in fact they could not.

Note how the IBM response is filled with CYA language, implying that their part in the failure is tiny. Were MNsure an unqualified success and glitch-free, I think the odds heavily favor an entirely different tone on the part of IBM and other private sector vendors associated with it.

Avoidance of responsibility is a corporate trait that's widespread. If Governor Dayton needs to "man up," so do the company CEOs whose firms failed to do what they said they could, and would, do. So far, at least, I see no sign of that taking place.

Whenever the public sector is forced to rely on the private sector the contracts should be written as so many of our state's road building and repair contracts have been written:

bonuses for work finished early and done well,...

and serious penalties for work done poorly, penalties which mount until ALL problems are resolved to the customer's (public entity's) satisfaction.

Clearly if IBM had had the contract to rebuild the 35W/Crosstown interchange, there'd be nothing there, yet, but mud, barriers, and ramps to nowhere, and the longer they took to finish it the more money they'd make,...

that "more money" coming directly out of the pockets of Minnesota taxpayers and getting dumped into the pockets of people who already have far more financial resources than the people being forced to pay for them for their inability to manage their own company's complex projects.

I've been right all along saying that Minnesota (Governor Dayton) should not have jumped into the exchange business for at least a year to let everyone else make all the mistakes and then take the best of what was working and eliminate what didn't. The Governor was the driving force behind this debacle. Please remember that this November. That, and the new Zigistadium.

Per a November 7 Fox News, 142,000 Minnesotans lost their health insurance policies when the base coverage requirements change. On November 18, Dayton declined to extend these policies, after Obama offered to extend them nationwide. In mid-December, barely a week before the initial sign-up deadline, Dayton expresses his concern about MNsure to IBM.

It's all to little to late. Through December 31, MNsure sold 25,860 Individual policies for private plans: I think it's highly unlikely that the other 116,140 persons found other private insurance.

To say nothing of the public plans. Any person on Minnesota Care or Medicaid has to renew through MNsure. I think that is going to be difficult for this population, many are disabled and have difficulty enrolling even if they are qualified. A story that hasn't been covered is how are the navigators and assistors getting paid if they cannot enroll clients, who is covering their salaries while MNsure is down? They were to get paid per enrollment.

IBM and the other vendors will get paid, maybe even more than the original contract to fix everything. The people that would have benefited from MNsure are the ones getting hurt.

On every ecommerce site in existence, you first browse around, find what you want to buy, and put it in the shopping cart. Than and only then do you provide personal and payment information before submitting your order for processing.

Healthcare.gov forces you to create an account and enter detailed personal information, including your social security number, before you can start shopping. This creates a massive bottleneck, as the government attempts to verify your information and decides whether or not you’re eligible for a subsidy. HHS knew this would make the website run more slowly, but they were more afraid that letting people see the actual cost of the insurance plans would scare people away.

Go to sites such as ehealthinsurance.com or healthplans.com, to see what I mean. You can be in and out of there with an insurance policy within a matter of minutes.

The source of the problems with the Obamacare sites is that even experienced private sector ecommerce site developers are having difficulty dealing with the government's "unusual" functional specs. No one does it this way. It's unprecedented and is probably in violation of HIPPA to ask you for your social security number before you even select what you're going to buy. What if you change your mind, like most shoppers at ecommerce sites do and decide to cancel your intended purchase? What happens to the personal data you've already entered?

Stand by for a flurry of class-action lawsuits of people who are concerned that their SSN has been compromised. Only unlike a bank card that's been compromised (ala Target), changing your SSN is unlikely.